TY - JOUR
T1 - Longitudinal Changes in Cardiac Troponin and Risk of Heart Failure Among Black Adults
AU - Saha, Amit
AU - Patel, Kershaw V.
AU - Ayers, Colby
AU - Ballantyne, Christie M.
AU - Correa, Adolfo
AU - Defilippi, Christopher
AU - Hall, Michael E.
AU - Mentz, Robert J.
AU - Seliger, Stephen L.
AU - Yimer, Wondwosen
AU - Butler, Javed
AU - Berry, Jarett D.
AU - De Lemos, James A.
AU - Pandey, Ambarish
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1
Y1 - 2023/1
N2 - Background: Among Black adults, high-sensitivity cardiac troponin I (hs-cTnI) is associated with heart failure (HF) risk. The association of longitudinal changes in hs-cTnI with risk of incident HF, HF with reduced and preserved ejection fraction (HFrEF and HFpEF, respectively), among Black adults is not well-established. Methods and Results: This study included Black participants from the Jackson Heart Study with available hs-cTnI data at visits 1 (2000–2004) and 2 (2005–2008) and no history of cardiovascular disease. Cox models were used to evaluate associations of categories of longitudinal change in hs-cTnI with incident HF risk. Among 2423 participants, 11.6% had incident elevation in hs-cTnI at visit 2, and 16.9% had stable or improved elevation (≤50% increase in hs-cTnI), and 4.0% had worsened hs-cTnI elevation (>50% increase). Over a median follow-up of 12.0 years, there were 139 incident HF hospitalizations (64 HFrEF, 58 HFpEF). Compared with participants without an elevated hs-cTnI, those with incident, stable or improved, or worsened hs-cTnI elevation had higher HF risk (adjusted hazard ratio 3.20 [95% confidence interval, 1.92–5.33]; adjusted hazard ratio 2.40, [95% confidence interval, 1.47–3.92]; and adjusted hazard ratio 8.10, [95% confidence interval, 4.74–13.83], respectively). Similar patterns of association were observed for risk of HFrEF and HFpEF. Conclusions: Among Black adults, an increase in hs-cTnI levels on follow-up was associated with a higher HF risk. Lay Summary: The present study included 2423 Black adults from the Jackson Heart Study with available biomarkers of cardiac injury and no history of cardiovascular disease at visits 1 and 2. The majority of participants did not have evidence of cardiac injury at both visits (67.5%), 11.6% had evidence of cardiac injury only on follow-up, 14.5% had stable elevations, 4.0% had worsened elevations, and 2.4% had improved elevations of cardiac injury biomarkers during follow-up. Compared with participants without evidence of cardiac injury, those with new, stable, and worsened levels of cardiac injury had a higher risk of developing heart failure. Tweet: Among Black adults, persistent or worsening subclinical myocardial injury is associated with an elevated risk of HF.
AB - Background: Among Black adults, high-sensitivity cardiac troponin I (hs-cTnI) is associated with heart failure (HF) risk. The association of longitudinal changes in hs-cTnI with risk of incident HF, HF with reduced and preserved ejection fraction (HFrEF and HFpEF, respectively), among Black adults is not well-established. Methods and Results: This study included Black participants from the Jackson Heart Study with available hs-cTnI data at visits 1 (2000–2004) and 2 (2005–2008) and no history of cardiovascular disease. Cox models were used to evaluate associations of categories of longitudinal change in hs-cTnI with incident HF risk. Among 2423 participants, 11.6% had incident elevation in hs-cTnI at visit 2, and 16.9% had stable or improved elevation (≤50% increase in hs-cTnI), and 4.0% had worsened hs-cTnI elevation (>50% increase). Over a median follow-up of 12.0 years, there were 139 incident HF hospitalizations (64 HFrEF, 58 HFpEF). Compared with participants without an elevated hs-cTnI, those with incident, stable or improved, or worsened hs-cTnI elevation had higher HF risk (adjusted hazard ratio 3.20 [95% confidence interval, 1.92–5.33]; adjusted hazard ratio 2.40, [95% confidence interval, 1.47–3.92]; and adjusted hazard ratio 8.10, [95% confidence interval, 4.74–13.83], respectively). Similar patterns of association were observed for risk of HFrEF and HFpEF. Conclusions: Among Black adults, an increase in hs-cTnI levels on follow-up was associated with a higher HF risk. Lay Summary: The present study included 2423 Black adults from the Jackson Heart Study with available biomarkers of cardiac injury and no history of cardiovascular disease at visits 1 and 2. The majority of participants did not have evidence of cardiac injury at both visits (67.5%), 11.6% had evidence of cardiac injury only on follow-up, 14.5% had stable elevations, 4.0% had worsened elevations, and 2.4% had improved elevations of cardiac injury biomarkers during follow-up. Compared with participants without evidence of cardiac injury, those with new, stable, and worsened levels of cardiac injury had a higher risk of developing heart failure. Tweet: Among Black adults, persistent or worsening subclinical myocardial injury is associated with an elevated risk of HF.
KW - Black adults
KW - heart failure
KW - high-sensitivity cardiac troponin I
UR - http://www.scopus.com/inward/record.url?scp=85135468455&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85135468455&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2022.05.013
DO - 10.1016/j.cardfail.2022.05.013
M3 - Article
C2 - 35690315
AN - SCOPUS:85135468455
SN - 1071-9164
VL - 29
SP - 6
EP - 15
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
IS - 1
ER -